贫血对老年社区获得性肺炎死亡的影响分析

Analysis of the effects of anemia on death in elderly patients with community-acquired pneumonia

目的探讨合并贫血的老年社区获得性肺炎(CAP)病人临床特征以及贫血对预后的影响。方法选取2022年1—12月住院治疗的323例老年CAP病人为研究对象,依据贫血诊断标准,分为贫血组(n=151)和非贫血组(n=172),比较2组一般资料、实验室指标、治疗结局和肺炎严重程度。采用Logistic回归分析实验室指标和贫血对老年CAP病人预后的影响。结果贫血组凝血酶原时间、凝血酶时间、D-二聚体、尿素氮、中性粒细胞与淋巴细胞比值(NLR)、重症肺炎例数较非贫血组高,CRP、淋巴细胞、总蛋白、白蛋白、白/球蛋白比值、间接胆红素、丙氨酸氨基转移酶、肌酸激酶同工酶水平低于非贫血组,差异有统计学意义(P<0.05);2组间白细胞计数、降钙素原差异无统计学意义(P>0.05)。Logistic回归分析结果显示,贫血、CRP、D-二聚体、NLR、尿素氮、肌酐水平是老年CAP病人死亡的独立影响因素(P<0.05)。结论贫血是影响老年CAP病人预后的独立危险因素,在临床诊疗中应加强对血红蛋白水平的管理。

Objective To investigate the clinical characteristics of the elderly patients with community-acquired pneumonia(CAP)combined with anemia and the impact of anemia on the prognosis of CAP.Methods A total of 323 elderly inpatients with CAP from January 2022 to December 2022 were selected as the research subjects.According to the diagnostic criteria for anemia,they were divided into anemia group(n=151)and non-anemia group(n=172).The general information,laboratory indicators,clinical outcomes and disease severity were recorded and compared between the two groups.Logistic regression was used to analyze the correlation of laboratory indicators or anemia with the prognosis of the elderly patients with CAP.Results The levels of prothrombin time,thrombin time,D-dimer,urea nitrogen,neutrophil to lymphocyte ratio(NLR)and the number of severe pneumonia cases in the anemia group were higher than those in the non-anemia group(P<0.05).The levels of C-reactive protein(CRP),lymphocyte,total protein,albumin,albumin-globulin ratio,indirect bilirubin,glutamic pyruvic transaminase and creatine kinase isoenzyme in the anemia group were significantly lower than those in the non-anemia group(P<0.05).There were no significant differences between the two groups in white blood cell count and procalcitonin(P>0.05).Logistic regression analysis showed that anemia,CRP,D-dimer,NLR,urea nitrogen and creatinine were the independent risk factors of death in the elderly patients with CAP(P<0.05).Conclusions Anemia is an independent risk factor for the death of the elderly patients with CAP.More attention should be paid to the hemoglobin management in clinical practice.